The Unfinished Revolution, Menstrual Equity as the Bedrock of Gender Equality in India

The Unfinished Revolution, Menstrual Equity as the Bedrock of Gender Equality in India

In the grand narrative of India’s development, the conversation around menstrual health has long been relegated to the shadows, whispered about in hushed tones, shrouded in stigma, and treated as a “women’s issue” rather than a fundamental public health and human rights imperative. However, the tide is turning. The concerted efforts of the government, civil society, and grassroots activists have begun to lift the veil of silence, positioning access to menstrual hygiene at the very heart of the struggle for gender equality. As rightly emphasized by Rekha Sharma, this is not merely about health; it is a multifaceted crusade for dignity, education, economic empowerment, and the creation of a truly equitable society. While significant progress has been made, the journey towards universal menstrual equity remains an unfinished revolution, demanding sustained focus, innovation, and a collective societal shift.

The State of the Issue: From Stigma to Statistical Progress

India is home to over 355 million menstruating women and girls, a number that underscores the monumental scale of the challenge. For generations, menstruation has been entangled in a web of taboos, myths, and restrictions, directly impacting the health, mobility, and self-esteem of a vast portion of the population. The consequences are stark: girls missing school, women dropping out of the workforce, and the perpetuation of harmful practices due to a profound lack of awareness and access.

The National Family Health Survey-5 (2019-21) serves as a critical barometer of change, revealing a heartening trajectory. The data shows a remarkable leap: the percentage of women aged 15-24 using hygienic methods of menstrual protection rose from 58% in NFHS-4 (2015-16) to 78% in NFHS-5. More specifically, the use of sanitary napkins surged from 42% to 64%. This 20-point jump in just a few years is not a coincidence; it is the direct result of targeted government policy and widespread advocacy.

The backbone of this national effort is the Menstrual Hygiene Scheme, implemented under the umbrella of the National Health Mission (NHM). The strategy is decentralized, empowering states to propose and implement plans based on local needs through the State Programme Implementation Plan (PIP) route. A key component of this scheme is the army of Accredited Social Health Activists (ASHAs). These community health workers are the foot soldiers of this revolution. They organize monthly meetings with adolescent girls to demystify menstruation, discuss health topics openly, and crucially, provide sanitary napkins at subsidized prices, ensuring that information and access go hand-in-hand.

Initiatives and Impact: A Multi-Pronged National Approach

The government’s approach has evolved from silence to structured support, recognizing that solving this complex issue requires both supply and demand-side interventions.

1. The Jan Aushadhi Suvidha Scheme: Affordability as a Right
A landmark initiative under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) is the Jan Aushadhi Suvidha Sanitary Napkin scheme. This program tackles one of the biggest barriers: cost. For many families, especially in low-income households, commercial sanitary products remain prohibitively expensive, often forcing women to resort to unhygienic alternatives like old rags, sand, or ash. The Suvidha napkins, available at over 15,000 Jan Aushadhi Kendras across the country, are sold for an incredible Re. 1 per pad. By making a safe, reliable product universally affordable, the government has democratized access to menstrual hygiene, treating it not as a luxury but as a non-negotiable essential.

2. The Shubhangi Initiative: A Blueprint for Holistic Empowerment
While government schemes provide the essential framework, the role of non-profits and foundations is pivotal in creating scalable, community-driven models. The Shubhangi Initiative, led by the Jindal Foundation, stands as a stellar example of a holistic approach that synergizes health, economic empowerment, and social change.

Operating on a social business model, the initiative does not just distribute sanitary napkins; it manufactures low-cost, high-quality napkins within rural communities. This model is transformative:

• Economic Empowerment: It involves local women in the production, distribution, and sales process, turning them from passive beneficiaries into active entrepreneurs—”Shubh Sahelis” ( auspicious friends). The initiative has generated over ₹11 crore in revenue, directly fostering financial independence for women in marginalized communities.

• Breaking Intergenerational Taboos: By employing older women in the production units, the initiative directly combats deep-seated myths and hesitancy that often prevent this demographic from adopting modern sanitary products. They become advocates within their own peer groups, normalizing the conversation.

• Scale and Sustainability: Having reached over one million women and girls across 3,000+ villages in states like Odisha, Chhattisgarh, Jharkhand, Haryana, and Delhi, the model proves that a solution can be both compassionate and commercially viable, ensuring its long-term sustainability without perpetual donor dependency.

The Road Ahead: Building on Progress to Achieve True Equity

Despite these advances, the mission is far from accomplished. A 78% usage rate of hygienic methods still leaves over 22% of young women—tens of millions—without access. True menstrual equity requires moving beyond just providing pads and tackling the interconnected barriers that persist.

1. The Infrastructure Gap: Beyond the Product
Access to a sanitary pad is meaningless without access to clean, safe, and private sanitation facilities. This remains a colossal challenge, particularly in rural areas, urban slums, and for the millions of women working in India’s vast informal sector. Schools without functional, separate toilets for girls are a primary reason for dropout rates post-puberty. Workplaces, from farms to factories, often lack basic facilities, forcing women to choose between their health and their livelihood. Investing in Water, Sanitation, and Hygiene (WASH) infrastructure is not a separate agenda; it is the foundational prerequisite for successful menstrual hygiene management.

2. The Knowledge Gap: Sustaining Educational Momentum
Awareness campaigns must intensify and evolve. While ASHAs are doing crucial work, educational efforts need to be integrated more formally into school curricula for all genders, normalizing menstruation as a biological process from a young age. Community programs must continue to dismantle harmful myths—such as those restricting movement, access to kitchens, or places of worship—that perpetuate stigma and shame. The conversation must include topics like Polycystic Ovary Syndrome (PCOS), endometriosis, and other menstrual disorders, ensuring women can seek help without embarrassment.

3. The Environmental and Choice Gap: Promoting Sustainable Options
The surge in disposable sanitary napkins, while a victory for health, presents a new environmental challenge. Promoting research, development, and awareness of sustainable alternatives like menstrual cups and biodegradable pads is essential for an ecologically responsible future. Women should be empowered with information to make choices that suit their bodies, lifestyles, and values.

4. The Policy Gap: Mainstreaming Menstrual Equity
Policy can be a powerful catalyst. Initiatives like the Menstrual Benefit Bill, which proposed paid leave for women suffering from severe period pain, spark important conversations about accommodating women’s health needs in public and professional life. While the implementation of such policies requires careful consideration, they signal a move towards recognizing menstrual health as integral to overall well-being.

Conclusion: A Collective Responsibility for a Dignified Future

The battle for menstrual equity is a microcosm of the larger fight for gender justice. It is a battle that must be fought on multiple fronts: in government corridors formulating policy, in classrooms educating young minds, in communities changing social norms, and in homes where open conversations between parents and children can break generational cycles of silence.

As a society, we must internalize that menstrual health is not a “women’s issue”; it is a social responsibility and a marker of a nation’s development. When a girl no longer misses school because of her period, her potential is unlocked. When a woman can work with dignity and comfort, she contributes more fully to the economy. When myths are replaced with knowledge, everyone benefits from healthier, more respectful communities.

The progress shown by the NFHS-5 data is a beacon of hope, proving that change is possible. Now, the task is to build on this momentum, to reach the last mile, and to ensure that every single one of India’s 355 million menstruators can manage their period with safety, confidence, and unshakeable dignity. The future we are building is one where menstruation is no longer a barrier, but a natural, accepted part of life—a future that is stronger and more equitable for everyone.

Q&A Section

Q1: What does the latest NFHS-5 data reveal about the progress in menstrual hygiene in India?
A1: The National Family Health Survey-5 (2019-21) shows significant improvement. The percentage of women aged 15-24 using hygienic methods of menstrual protection increased dramatically from 58% in NFHS-4 (2015-16) to 78% in NFHS-5. A key component of this is the rise in the use of sanitary napkins, which jumped from 42% to 64% in the same period. This indicates a positive shift towards better health practices and awareness among young women.

Q2: Who are ASHAs and what is their role in the Menstrual Hygiene Scheme?
A2: Accredited Social Health Activists (ASHAs) are community health workers who form the grassroots-level implementation arm of the National Health Mission. In the context of menstrual hygiene, their role is twofold. First, they organize monthly meetings with adolescent girls in their communities to educate them about health, including demystifying menstruation and teaching menstrual hygiene management. Second, they act as distribution agents, providing sanitary napkins to girls and women at subsidized prices, ensuring last-mile access to essential products.

Q3: How does the Jan Aushadhi Suvidha scheme address the issue of affordability?
A3: The Jan Aushadhi Suvidha scheme, under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), directly tackles the financial barrier to menstrual hygiene. It makes high-quality sanitary napkins available at a massively subsidized price of just ₹1 per pad at over 15,000 Jan Aushadhi Kendras nationwide. By making this basic health product virtually accessible to all income groups, the scheme redefines menstrual care from a luxury item to an affordable essential, a fundamental right for every woman.

Q4: The Shubhangi Initiative is praised as a holistic model. What makes it so effective?
A4: The Shubhangi Initiative’s effectiveness lies in its integrated, multi-dimensional approach that goes beyond mere distribution.

• Economic Empowerment: It employs a social business model, involving local women in manufacturing and selling napkins, turning them into entrepreneurs (“Shubh Sahelis”) and generating significant revenue that stays within the community.

• Social Change: By employing older women, it breaks taboos within demographics that are often most resistant to change, using them as agents of awareness.

• Sustainability: Its commercial viability ensures it is not donor-dependent, allowing for long-term operation and scalability across thousands of villages.
  It successfully links health access with livelihood generation and cultural shift.

Q5: What are the remaining major challenges in achieving full menstrual equity in India?
A5: Despite progress, key challenges persist:

• Infrastructure: The lack of clean, private, and safe Water, Sanitation, and Hygiene (WASH) facilities in schools, workplaces, and public spaces remains a huge barrier.

• Persistent Taboos: Deep-rooted social stigmas and myths still restrict women’s lives and prevent open conversation, especially in rural areas.

• Environmental Sustainability: The waste generated by disposable sanitary products is an emerging problem that needs addressing through promotion of sustainable alternatives.

• Reaching the Last Mile: Ensuring that schemes and products reach the most marginalized communities, including those in remote areas and the urban informal sector, is an ongoing logistical challenge.